Excisional debridement is surgical removal (cutting away) of tissue, necrosis, or slough. In ICD-10-PCS, this type of debridement is classified to the root operation of “Excision”. Excisional debridement involves the use of a sharp instrument, like a scalpel, to cut away/remove devitalized tissue.
A code for excisional debridement is assigned when the physician documents “excisional debridement” or if the physician has clearly documented removal of tissue by excision (cutting out or off, without replacement, a portion of a body part).
The use of a sharp instrument alone is not sufficient for reporting excisional debridement. Documentation of knife dissection or minor cutting away of loose tissue with scissors is not sufficient for reporting the root operation of “Excision”.
Non-excisional debridement is the nonoperative brushing, irrigating, scrubbing, or washing of devitalized tissue, necrosis, slough, or foreign material. Most non-excisional debridement procedures will be classified to the root operation of “Extraction” (pulling or stripping out or off all of a portion of a body part by the use of force). Debridement using a Versajet Debrider is reported as a non-excisional debridement.
When both excisional and non-excisional debridement are performed at the same site, excision is the definitive treatment, so only the code for excisional debridement would be assigned .
Physicians are not required to document in ICD-10-PCS terminology, so it is the coder’s responsibility to read the operative/procedure note and determine which ICD-10-PCS root operation the documentation equates to..
References:
ICD-10-PCS Official Guidelines for Coding and Reporting
AHA Coding Clinic, First Quarter 2013 Pages: 15
AHA Coding Clinic, Third Quarter 2015; Pages 3-8
AHA Coding Clinic, Third Quarter 2016 Pages: 20-22
AHA Coding Clinic, First Quarter 2018 Pages: 14-15
AHA Coding Clinic, Third Quarter 2018 Pages: 17-18
AHA Coding Clinic, Second Quarter 2020 Page: 26
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